Does it matter if it is appendix mucocele instead of appendicitis? Case series and brief review of literature

Başak, Fatih; Hasbahçeci, Mustafa; Yücel, Metin; Şişik, Abdullah; Acar, Aylin; Kılıç, Ali; Dur, Meliha Seyma Su

doi:10.4103/0973-1482.183193

Cited by 9 publications

(11 citation statements)

References 16 publications

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“…Um estudo mostrou, em uma série de onze casos, leucocitose em sete pacientes, anemia em quatro pacientes (os quais necessitaram de transfusões sanguíneas) e alguns marcadores tumorais como o antígeno carcinoembrionário e o antígeno de câncer 19-9 presentes e normais em três pacientes. O que evidencia o valor genérico de testes laboratoriais, os quais não auxiliam diretamente a fechar um diagnóstico 7 .…”

Section: Discussionunclassified

Mucocele de apêndice: relato de caso

Chalub¹,

Spaziani²,

Frota³

et al. 2020

Arch Health Invest

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Introdução: A mucocele do apêndice é um termo utilizado para descrever uma dilatação deste órgão, devido ao acúmulo de secreção mucoide, tornando o apêndice dilatado, de paredes finas e com uma massa cística no seu interior. Na maioria dos casos a mucocele é resultante de neoplasia que obstrui a luz apendicular. Relato de caso: Sexo feminino, 55 anos, branca. Procurou atendimento médico devido à dor abdominal de moderada intensidade há cinco anos. Refere que os sintomas iniciaram com dor em fossa ilíaca direita e região lombar há cinco anos, quando começou a tratar lombalgia. Nesse ano, buscou atendimento graças a piora da dor. O abdome estava globoso, flácido, doloroso a palpação superficial e profunda em fossa ilíaca direita com ruídos hidroaéreos presentes. Devido a sintomatologia foram solicitados um ultrassom de abdome total que evidenciou imagem cística tubuliforme em região anexial direita, de aspecto simples, de contornos regulares e conteúdo anecoico, medindo 13,3 cm x 5,2 cm x 4,3 cm, sem septos, calcificações ou fluxo ao Doppler e ressonância magnética da pelve que demonstrou formação cística alongada em região anexial, mergulhante na região anexial, apêndice cecal não individualizado. Foi realizada uma cirurgia exploradora que resultou em apendicectomia e o produto enviado para análise histopatológica que resultou em mucocele de apêndice, sem critérios histológicos de malignidade. As mucoceles de apêndice foram classificadas em 3 categorias: hiperplasia mucosa sem atipias, mucocele simples; cistadenoma mucinoso, com algum grau de atipia e cistadenocarcinomamucinoso, com invasão estromal ou implantes peritoniais. Conclusão: A sintomatologia é a dor abdominal, de intensidade e duração variáveis, podendo também ser observados a presença de massa palpável em fossa ilíaca direita e emagrecimento. Embora cerca de 25% dos casos sejam assintomáticos, alguns estudos demonstram a correlação entre sintomatologia exuberante e displasia. Aproximadamente 20% dos casos de mucocele de apêndice têm associação com o câncer colorretal, no entanto, outras neoplasias como os carcinomas de ovário, endométrio, mama, próstata, bexiga e rim também podem estar presentes.Descritores: Mucocele; Apêndice; Dor Abdominal.ReferênciasEnsuncho C, Osorio C, Marrugo Á, Herrera F. Obstrucción intestinal parcial producida por mucocele apendicular con fístula a íleon proximal. rev colomb cir. 2016;31(1):61-4.Bichara DSJ, Luz Neto VC, Matuck MJ, Bichara DG. Pseudomixoma retroperitoneal (mucocele apendicular). Relatos Casos Cir. 2015;(1):1-3Moré Cabrera JA, León Aulla SP, Pérez Zavala GA. Presentación inusual de mucocele apendicular. Acta Médica Centro. 2015;9(4):62-7.Morano WF, Gleeson EM, Sullivan SH, Padmanaban V, Mapow BL, Shewokis PA et al. Clinicopathological features and management of appendiceal mucoceles: A systematic review. Am Surg. 2018;84(2):273-81.Park KJ, Choi HJ, Kim SH. Laparoscopic approach to mucocele of appendiceal mucinous cystadenoma: Feasibility and short-term outcomes in 24 consecutive cases. Surg Endosc. 2015;29(11):3179-83.Demetrashvili Z, Chkhaidze M, Khutsishvili K, Topchishvili G, Javakhishvili T, Pipia I et al. Mucocele of the appendix: case report and review of literature. Int Surg. 2012;97(3):266-69.Basak F, Hasbahceci M, Yucel M, Sisik A, Acar A, Kilic A, Su Dur MS. Does it matter if it is appendix mucocele instead of appendicitis? Case series and brief review of literature. J Cancer Res Ther. 2018;14(6):1355-60.Rabie ME, Al Shraim M, Al Skaini MS, Alqahtani S, El Hakeem I, Al Qahtani AS et al. Mucus containing cystic lesions “mucocele” of the appendix: the unresolved issues. Int J Surg Oncol. 2015;2015:139461.Hao S, Lilly R, Bonatti HJR. Laparoscopic resection of an appendix mucocele in a breast cancer patient. Case Rep Surg. 2018;2018:1780342.Dixit A, Robertson JH, Mudan SS, Akle C. Appendiceal mucocoeles and pseudomyxoma peritonei. World J Gastroenterol. 2007;13(16):2381-84.

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Section: Discussionunclassified

Mucocele de apêndice: relato de caso

Chalub¹,

Spaziani²,

Frota³

et al. 2020

Arch Health Invest

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“…AM was first described in 1842 by Rokitansky and is an unspecific term used to define cystic dilation of the appendix caused by accumulation of mucus secretion. AM is a rare disease found in < 1% of all appendectomy specimens and misdiagnosed as acute appendicitis or pelvic mass or retroperitoneal tumors in many cases, because the most frequent symptom is acute or chronic right lower quadrant abdominal pain [1, 2, 3, 4]. It can be diagnosed at any age and should be considered in the differential diagnosis of acute abdominal pain at any age.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment depends on the size of the appendix and on the histological type of the original lesion. Surgical resection is the treatment modality of choice, and surgical approaches either by laparoscopic or open surgery and extension by only appendectomy or right hemicolectomy are not defined clearly [3, 7]. However, it is very important to select an appropriate surgical method to prevent complications.…”

Section: Discussionmentioning

confidence: 99%

“…Appendiceal mucocele (AM) is a rare condition, accounting for 0.3–0.7% of appendiceal pathology, comprising 8% of appendiceal tumors, and is found in <1% of all appendectomy specimens [1, 2, 3]. It is often misdiagnosed as appendicitis, pelvic mass, or retroperitoneal tumor in many cases because the most frequent symptom is right lower quadrant abdominal pain [3, 4]. AM can be diagnosed at any age and should be considered in the differential diagnosis of abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

“…AM can be diagnosed at any age and should be considered in the differential diagnosis of abdominal pain. Although there are pathological classifications, surgical resection is the accepted treatment modality for each histological type to prevent the development of peritoneal pseudomyxoma (PP) that is associated with a high mortality rate [1, 2, 3, 4]. However, preoperative diagnosis of AM is difficult because of the non-specific clinical manifestations of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Rare Cases of Low-Grade Appendiceal Mucinous Neoplasm: Two Case Reports and a Literature Review

et al. 2019

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Appendiceal mucocele (AM) is rare disease found in <1% of all appendectomy specimens. AM is often misdiagnosed as appendicitis because the most frequent symptom is right lower quadrant abdominal pain. AM should be considered in the differential diagnosis of abdominal pain. Although there are pathological classifications, surgical resection is accepted as the treatment to prevent the development of peritoneal pseudomyxoma (PP); however, the optimal surgical technique that must be used is unclear. We present two cases suspected of being AM prior to surgery that were pathologically diagnosed as low-grade appendiceal mucinous neoplasms. Each case progressed without developing PP. The surgical procedures we chose are considered appropriate for each case.

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A CT-based radiomics nomogram involving the cystic fluid area for differentiating appendiceal mucinous neoplasms from appendicitis with intraluminal fluid

Wang,

Feng,

Qiu

et al. 2024

J Cancer Res Clin Oncol

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Objective To develop and validate a radiomics nomogram based on computed tomography (CT) to distinguish appendiceal mucinous neoplasms (AMNs) from appendicitis with intraluminal fluid (AWIF). Method A total of 211 patients from two medical institutions were retrospectively analysed, of which 109 were pathologically confirmed as having appendicitis with concomitant CT signs of intraluminal fluid and 102 as having AMN. All patients were randomly assigned to a training (147 patients) or validation cohort (64 patients) at a 7:3 ratio. Radiomics features of the cystic fluid area of the appendiceal lesions were extracted from nonenhanced CT images using 3D Slicer software. Minimum redundancy maximum relevance and least absolute shrinkage and selection operator regression methods were employed to screen the radiomics features and develop a radiomics model. Combined radiomics nomogram and clinical-CT models were further developed based on the corresponding features selected after multivariate analysis. Lastly, receiver operating characteristic curves, and decision curve analysis (DCA) were used to assess the models’ performances in the training and validation cohorts. Results A total of 851 radiomics features were acquired from the nonenhanced CT images. Subsequently, a radiomics model consisting of eight selected features was developed. The combined radiomics nomogram model comprised rad-score, age, and mural calcification, while the clinical-CT model contained age and mural calcification. The combined model achieved area under the curves (AUCs) of 0.945 (95% confidence interval [CI]: 0.895, 0.976) and 0.933 (95% CI: 0.841, 0.980) in the training and validation cohorts, respectively, which were larger than those obtained by the radiomics (training cohort: AUC, 0.915 [95% CI: 0.865, 0.964]; validation cohort: AUC, 0.912 [95% CI: 0.843, 0.981]) and clinical-CT models (training cohort: AUC, 0.884 [95% CI: 0.820, 0.931]; validation cohort: AUC, 0.767 [95% CI: 0.644, 0.863]). Finally, DCA showed that the clinical utility of the combined model was superior to that of the clinical CT and radiomics models. Conclusion Our combined radiomics nomogram model constituting radiomics, clinical, and CT features exhibited good performance for differentiating AMN from AWIF, indicating its potential application in clinical decision-making.

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Does it matter if it is appendix mucocele instead of appendicitis? Case series and brief review of literature

Cited by 9 publications

References 16 publications

Mucocele de apêndice: relato de caso

Mucocele de apêndice: relato de caso

Rare Cases of Low-Grade Appendiceal Mucinous Neoplasm: Two Case Reports and a Literature Review

A CT-based radiomics nomogram involving the cystic fluid area for differentiating appendiceal mucinous neoplasms from appendicitis with intraluminal fluid

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